O cuidado de enfermagem no manejo da mucosite e da neutropenia febril por antineoplásicos como complicação das leucemias: revisão integrativa da literatura

Abstract

Introduction: Within the group of cancers are leukemias, the most frequent are: acute myeloid leukemia (AML) acute lymphoid leukemia (ALL), chronic myeloid leukemia (CML) and chronic lymphoid leukemia (LLC). The main feature of this cancer is the accumulation of immature white cells that multiply quickly and end up replacing healthy cells causing disorder in the body. Aggressive treatment causes many complications, among the most complained are mucositis and neutropenia induced by chemotherapy. Nursing care is essential in the treatment as well as in the prevention of complications. Objective: To determine what evidence in the literature about nursing care in the complications of leukemia. Method: This is an integrative literature review, in which the databases: LILACS, PUBMED, COCHRANE CINAHL and EMBASE were used. The 12 studies found were divided into two outcomes: 1 Mucositis, 2 febrile neutropenia induced by chemotherapy. In outcome number 1, the main topics investigated were the incidence of mucositis, the relationship between mucositis and age, nursing care and non pharmacological care and protocols for assessing mucositis. In outcome number 2, incidence, relationship with mucositis, nursing care, mainly in the elaboration of risk classification and prevention protocols and protocols to stratify risk of developing neutropenia, were investigated. Results: Of the studies found in relation to the publication period, one study was from the year 2011, one study from the year 2013, three studies from the year 2014, three studies from the year 2015. From the years 2017 and 2019, three and one studies were found, respectively. The studies of the present IR were grouped into two outcomes: Mucositis and Febrile Neutropenia, 6 for mucositis and 4 for febrile neutropenia. Two studies addressed the two outcomes. The levels of evidence in the studies were levels 2, 3, 4 and 6. Discussion: Most of the articles presented data associated with high leukemia mortality. The reason would be the complications that can often lead the patient to death. The prevalence of leukemia was in the male population, corroborating with data from the National Cancer Institute, which places leukemia more frequently in men than in women. The studies showed the non drug treatment of mucositis, as well as the risk classification of these patients and protocols for nursing care. The nurse was the most capable professional to be in charge of the cases, the data corroborate with several current studies that show the presence and action of nursing in oncology. Regarding neutropenia, risk classification protocols, case studies and the relationship between neutropenia and mucositis were used. In all, the nurse's participation was essential. Conclusion: There is a large gap in studies related to nursing care directly in the complications of cancer, however the present study may indicate new research in the area. Onco--hematology is little explored. The present study provided subsidies for oncology nurses to incorporate in their research in order to demonstrate the important work that nursing plays in the complications of cancer.